Nodal detection in malignant melanoma of the vagina using laparoscopic ultrasonography.

BACKGROUND: Primary malignant melanoma of the vagina is a rare variant of melanoma. It has worse prognosis compared to nongenital melanomas or other vaginal malignant neoplasms.

CASE: A 40-year-old Chinese was diagnosed vaginal melanoma. Laparoscopic ultrasonography (USG) was used to search for abnormal pelvic and abdominal lymph nodes. Two metastatic pelvic lymph nodes were detected and excised. The vaginal tumour was removed by hysterectomy and partial vaginectomy. Despite a clear surgical margin and adjuvant radiotherapy, the patient died shortly after the operation.

CONCLUSION: Patient with vaginal melanoma has grave prognosis, especially when metastatic disease presents. Radical surgery appears unjustified as a routine, it is essential to exclude lymphatic and distant metastases before embark to radical surgery. This report presents the first case of laparoscopic ultrasonographic detection of metastatic pelvic lymph nodes in patient with vaginal melanoma.